The present invention relates generally to the feeding of a patient, through a tube, with an enteral product. More specifically, the present invention relates to the prevention of diarrhea in a tube-fed patient.
It is known to feed patients, requiring nutrition in a hospital or other healthcare setting (including a home), with an enteral or parenteral nutritional solution. Parenteral nutritional solutions include solutions that are infused into the venous system of a patient through an IV system. Enteral products include products that are fed to a patient through a tube that is fed through the nasogastric system.
Although enteral products fed through a nasogastric tube can provide a patient with total nutritional requirements, there are, in certain patients, some side effects from such feedings. In this regard, it is known that certain patients will experience diarrhea when tube fed enteral nutritional products.
Diarrhea is cited as the most common cause of interrupted tube feeding. Likewise, diarrhea is cited as the most frequent complaint of tube-fed patients. Many hospital nurses, dietitians, and physicians have identified the reduction of diarrhea as being one of the most desirable areas of patient care. In this regard, diarrhea effects approximately 10 to 40% of the tube-fed hospitalized patients. It is also know, to a lesser extent that tube-fed patients experience nausea and abdominal distension.
To help to reduce the incidence of diarrhea, it is known to put fiber or other anti-diarrhea composition in enteral formulations. Due to problems with keeping a particulate substance in suspension, only a certain amount of fiber can be loaded in a typical enteral formulation. For example, typical fiber containing enteral products include 14 grams of insoluble soy polysaccharide (fiber) per liter and have a caloric density of 1.0 Kcal/ml.
The addition of insoluble fiber, however, does not eliminate the incidence of diarrhea. Therefore, it is common practice in U.S. hospitals, when faced with a tube-fed patient with diarrhea, to initially reduce the flow rate and/or concentration of the enteral product. It is expected that because fluid volume and osmolality are reduced, the diarrhea will also be reduced.
Accordingly, hospitals dilute such enteral products to three-quarter to one-half strength. This reduces nutrient load, theoretically reducing malabsorption, and also reduces osmolality. Although improvements should be expected when the fluid volume and osmolality of an enteral product are reduced, to achieve the reduced osmolality, the hospital merely dilutes the product. For example, the product is mixed with water so as to be diluted to 50%.
The disadvantage of this procedure is that the fiber, or other anti-diarrhea composition, in the enteral product is likewise reduced. Therefore, the dilution of the product does not always result in a reduction in the severity of the diarrhea. Furthermore, the dilution process can compromise the sterility of the enteral product. Still further, because the product is diluted, essential vitamins and minerals are not supplied in adequate quantity.